Cognitive Behaviour Therapy for insomnia in chronic pain sufferers-Milton Keynes Hospital NHS Trust

ADOPTION

WHAT IS THE ISSUE?

7.8 million people in the UK have chronic pain (CMO Report 2008). The National Sleep Foundation reports that two thirds of chronic pain sufferers experience sleep problems. A vicious circle operates: sleep disruption caused by chronic pain exacerbates pain which interrupts sleep and sleep deprivation has been shown to reduce pain thresholds and induce pain in healthy individuals.

WHAT IS THE INNOVATION?

The project will pilot a six week Cognitive Behaviour Therapy (CBT) programme for people with chronic pain and associated sleep problems. CBT has been shown to be an effective treatment for insomnia and chronic pain independently. Several trials (Currie et al 2000 & Edinger et al 2005) have been conducted on the effectiveness of using CBT to combat secondary insomnia in chronic pain sufferers to good effect, and Gloucestershire and Herefordshire Pain Management Service, Gloucestershire Hospitals NHS Foundation Trust recommend the use of CBT for chronic pain sufferers with insomnia. The project will be based upon work carried out by Professor Colin Espie at the Glasgow Sleep Centre in relation to overcoming insomnia and sleep problems. This programme has been piloted for cancer pain patients, but not with patients with chronic pain of any other genesis thus far.

WHAT IS THE BENEFIT?

For patients/staff/service

• Improved quality and quantity of sleep.
• Decreased fatigue and restrictions in daily life.
• Increased concentration and ability to cope with pain.
• Positive family benefits.
• Holistic chronic pain approach for staff.

Increased quality and productivity

• Reduction in medication use.
• Reduction in frequency of GP visits.
• Reduction in visits to pain clinic.

Spread and sustainability

• Programme adapted to address other chronic long term conditions.
• Publication of work in journals and dissemination at pain and psychology conferences.
• Local pain network disseminates knowledge locally.

Projected savings

• £7,000 per programme running costs, quantification of  savings to be captured by the pilot.